ObjectiveTo get known of the application of Preferred Items of Systematic Review and Meta Analysis (PRISMA). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 10, 2013), CBM, WanFang Data and CNKI, to collect relevant literature about the application of PRISMA during 2009-2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and then bibliometric analysis was performed using Excel software. ResultsWe finally included 175 papers, including 26 conference abstracts and 149 full texts. The results of bibliometric analysis of full texts showed that, they were published in 118 journals, and PRISMA official website announced that 176 journals endorsed the application of PRISMA. According to study type, there were 111 systematic reviews and meta-analyses (SRs/MAs) for development and reporting, 20 overviews of SRs for reporting quality assessments, 7 versions of PRISMA interpretation, and 11 articles of other kinds. In 131 SRs/MAs as well as overviews, the studies about western medicine accounted for 77.8%, followed by public health (8.4%), and traditional Chinese medicine (4.6%). ConclusionThe application of PRISMA statement is still at the first phase and mainly confined to the field of western medicine, which needs more attention and understanding. Thus, it's necessary to interpret and disseminate the PRISMA statement.
目的 探討胰頭部腫塊型慢性胰腺炎的診斷要點與個體化術式的選擇原則。方法 回顧性分析2000年4月至2011年9月期間我院收治的10例胰頭部腫塊型慢性胰腺炎患者的臨床資料。結果 本組平均發病年齡47.3歲,平均病程69.1d,平均總膽紅素99.4μmol/L,CA19-9 55~78U/ml。10例B超檢查示肝內膽管及膽總管擴張,5例CT檢查報告胰頭部占位性病變伴主胰管不規則擴張或鈣化灶,2例MRCP檢查診斷膽總管下段占位。3例術中多點穿刺快速活檢后行膽胰管引流術,7例術前誤診為胰頭癌或壺腹癌均行胰十二指腸切除,術后出現并發癥8例,死亡1例,9例平均隨訪44.2個月無復發和癌變。結論 把握發病年齡、病程、波動性黃疸等臨床特征和CA19-9水平及CT、MRCP等影像檢查要點是胰頭部腫塊型慢性胰腺炎與胰頭癌鑒別診斷的關鍵,用個體化術式合理實施胰十二指腸切除、膽胰管內外引流術是胰頭部腫塊型慢性胰腺炎外科處理明智的選擇。
The financial conflict of interests is drawing a wide attention, while several problems such as the unclarity of definition and blurred boundary of classification exist when it comes to the nonfinancial conflict of interests. Taking clinical practice guidelines as the example, this study introduce how nonfinancial conflict of interests happen, their classifications and impact based on present situation of relevant studies.
Adapting the existing guidelines in the context of specific regions can improve the efficiency of guidelines development, and reduce cost and time for developing guidelines. ADOLOPMENT is a methodological tool for guidelines adaptation, which was developed by the GRADE Working Group based on the standardized international guidelines making process. With ADOLOPMENT, developers can effectively use existing guidelines and evidence, avoid duplication of the evidence evaluation, and record the process from evidence to recommendations, which will ensure the transparency of adaptation, help users to understand the process, and improve the acceptability and credibility of guideline adaptation. This paper aims to introduce the ADOLOPMENT and its application.
The focus of health equity is to enable the public to have fair access to health services and achieve satisfactory health outcomes. With research developments, guideline developers increasingly pay more attention to the fairness in the practice guidelines and have carried out exploration and practice in the relevant guidelines. The GRADE working group has begun to investigate how to use GRADE to assess health equity in practice guidelines since 2014. In 2017, the series of methodological guidelines of health equity in guideline development was officially published. It proposed 5 approaches to evaluate health equity and pointed out current methodological challenges of applying GRADE to assess health equity. This paper aims to introduce the GRADE equity guidelines, so as to provide a reference for Chinese researchers in their practice.
Surgical management of osteoarthritis of the knee: evidence based guideline contains 38 recommendations pertaining to the preoperative, perioperative, and postoperative care of patients with knee osteoarthritis (KOA) who are considering surgical treatment. Compared with the domestic consensus on diagnosis and treatment for KOA, this clinical practice guideline (CPG) prepared by the American Academy of Orthopedic Surgeons (AAOS) has some advantages in terms of methodology selection and recommendation. Therefore, it is necessary for us to interpret this CPG to speed up the understanding and dissemination of the CPG. The ultimate aims are to: ① strengthen the standardization and understanding of surgical treatment of KOA; ② enhance the understanding of clinicians for this CPG in treating KOA; ③ speed up the development of guideline development methodologies in China; ④ provide methodological guidance for the development of CPG based on the current situation in China.
In response to the public health emergency and other urgent needs, World Health Organization (WHO) developed the concept and methodology of rapid advice guidelines (RAGs) in 2006. Compared with the standard guideline, striving to minimize the risk of bias, the RAG shortens the time to 1-3 months from more than 2 years. This study introduces the background, definition, application condition and performing methods of RAGs, and uses an example to clarify it, thus to provide a reference for the guideline development of public health emergency and other urgent need in China.
The methodology of conducting systematic review of prognostic studies has received a great deal of interest in recent years. Using GRADE for systematic review of prognostic studies, five aspects should be considered:risk of bias, indirectness, inconsistency, imprecision and publication bias. The methods of using GRADE system in systematic review of prognostic studies are similar to systematic review of interventional studies, meanwhile, there are differences. Not only the uniqueness of prognostic study but also the repeating downgrade should be taken into consideration in the GRADE process. Applying GRADE to systematic review of prognostic studies would be widely accepted along with the methodology development and quality improvement of systematic review of prognostic studies.